<div class = "panel panel-info">
	 <div class="panel-heading">{{'ReinsuranceInfo' | translate}}</div>
	 <div class="panel-body">
	 
		<form class ="form-horizontal">
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="ReinsuranceInfo.externalSinisterNumber"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.externalSinisterNumber">
	    		</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="ReinsuranceInfo.codePTF"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.codePTF">
	    		</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="ReinsuranceInfo.policyConventionNumber"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.policyConventionNumber">
	    		</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="ReinsuranceInfo.codeSubsidiary"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.codeSubsidiary">
	    		</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="ReinsuranceInfo.codeAbi"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.codeAbi">
	    		</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="ReinsuranceInfo.codeCab"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.codeCab">
	    		</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="ReinsuranceInfo.avivaNumber"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.avivaNumber">
	    		</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="ReinsuranceInfo.avivaReceptionDate"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.avivaReceptionDate">
	    		</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="ReinsuranceInfo.bankCode"></label>
				<div class="col-sm-3">
	      			<input type="text" class="form-control" ng-model="reinsuranceInfo.bankCode">
	    		</div>
			</div>
		</form>
	</div>
</div>